The Government's troubled health reforms have cleared the Commons but ministers will be braced for further difficulties in the House of Lords.

The Health and Social Care Bill received its third reading by 316 votes to 251, Government majority 65.

Prime Minister David Cameron insisted the shake-up would create a "stronger NHS" and improve patient outcomes.

Speaking at Prime Minister's Questions, he said: "The point of our health reforms is to put doctors in charge, give patients greater choice and heal the divide between health and social care. I believe that they will lead to a stronger NHS and better outcomes for patients."

The reforms have endured a rough ride, with progress on the plans "paused" earlier this year following criticism from health professionals and patients groups.

Following a "listening exercise" the Bill was sent back to committee in the Commons for a series of revisions, including giving health professionals other than GPs power over how NHS funds are spent, stronger safeguards against a market free-for-all and scrapping a 2013 deadline for the introduction of new commissioning groups.

But as well as facing opposition from Labour and creating concerns for the unions and medical royal colleges, the plans have also exposed fault lines within the coalition.

Now the Bill has cleared the Commons it heads to the Lords, where Lib Dem grandee Baroness Williams is set to play a major role after she said she still has concerns over the influence of the private sector and warned the "battle is far from over".

Health Secretary Andrew Lansley said: "The intensity of debate and the brightness of the spotlight shone upon this Bill has made it a better Bill than when it was first laid before the House. I believe it will set the NHS in England on a path of excellence: empowered patients, clinical leadership and a relentless focus on quality."

But shadow health secretary John Healey said: "This Government and this Bill are giving health reform a bad name. It's unwanted and unnecessary. It's reckless to force through the biggest reorganisation in NHS history at the same time that finances are tight and pressures on the health service are growing."